Phenytoin Flashcards

1
Q

None linear kinetics is what

A

saturable meaning Cl and VD will change with doses and we cannot predicted half life

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2
Q

what is conatsnt in linear kinetics

A

AUC, Cmax and Css

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3
Q

Satuarble kinetics as concentration rises what happens to clearance?

Clinical indications of this?

A
  1. clearence decreases
  2. making it very difficult to use to interpret doses or uses intitae dose changes
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4
Q

what is mixed-order pharmacokinetics

A

displaying first first order at low concentrtaions then zero order kientics at high concentrations

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5
Q

at low concenrtaions what kinetics do you expect for mixed order

A

first order

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6
Q

at high concentrations what kinetics do you expect for mixed order

A

zero order

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7
Q

in non-linear kinetics if MD is increase what kind of effect do we expect in the plasma cocnentraion

A

since the Cl decreases with more drug we see a disproportional rise in plasma concentration

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8
Q

when do drugs swithc from first order to zero order kinetics in mixed?

EX: phenytoin and theophylline

A

depedn on drug

Phenytoin - at therpautic levels

Theophylline at toxic level

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9
Q

what models decribes saturable enxymes

A

michealis menton kinetics

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10
Q

based off M-M kinetics at low concentration of CSS increase in CSS cause what to happen to elimination

A

proprotional increase in elimination

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11
Q

based off M-M kinetics at very high concentration of CSS increase in CSS cause what to happen to elimination

A

very little change in elimination

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12
Q

in M-M kinetics what happens with increase of CSS?

A

as css increase the increase in elimination dampen

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13
Q

what is Vm mean

A

the maximum rate of elimiantion in a certain time

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14
Q

what is Km

A

drug concentration when elimination is working at half capacity (half max rate)

point above which drug stauartion is likely

called the Michaelis constant

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15
Q

KM and affinty

low km

high km

A

inverse relation

low km - high affinity

high km - low affinity

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16
Q

relationship bw cp, km, and vmax

if cp»>km

A

stauation condition

elimiantion rate is indepednt of Cp

17
Q

relationship bw cp, km, and vmax

if cp«<km

A

non-stauaation kinetics

elimination is depedent on Cp

18
Q

time to steady state linear kinetics

A

5-7 half lives

19
Q

time to steady sate non-linear kinetics

A

we can’t use the half life rule so we look at time to 90% of CSS so t90

20
Q

how to make a linear representative of non-linear kinetics

A

y-intercept = 1/vmax

slope = km/vmax

X intercepit = 1/km

x-axis in 1/css
y-axis is 1/dose (mg/day)

21
Q

increase in km means what for affinty, realistically whats happening, and Cp

A
  • less affinity
  • with co-administration of competitive enzyme inhibitors
  • at lower concentration less CP means rate of metabolism is less
    at normal km then cp is higher
22
Q

Decrease km

A
  • higher affinity
  • co-administration of other drugs that displace our drug from plasma proetisn
  • relatively small Cp measure
23
Q

increased vmax

A
  • maxmate rate of enxymes molcules increAse for metabolism
  • enzyme inducer
  • reduced Cp across all ranges
24
Q

decreased vmax

A
  • decrease in enxymes for metabolism
  • disease states
  • increase plasma concatention